Published on 25/03/2015 by admin
Filed under Pediatrics
Last modified 25/03/2015
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Chapter 342 Treatment of Pancreatic Insufficiency
Steven L. Werlin
Treatment of exocrine pancreatic insufficiency by oral enzyme replacement usually corrects creatorrhea, but steatorrhea is difficult to correct completely. This may be due to inadequate dosage, incorrect timing of doses in relation to food consumption or gastric emptying, lipase inactivation by gastric acid, and the observation that chymotrypsin in the enzyme preparation digests and thus inactivates lipase. In 2010 the FDA removed all pre-existing enzyme preparations from the U.S. market. The previous practice of overfilling capsules was banned. To date, 3 new preparations have been approved. All have been tested and shown to reduce malabsorption in cystic fibrosis patients. Modern enzyme products are enteric-coated to resist gastric acid inactivation.
Nelson Textbook of Pediatrics Expert Consult
